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Recurrent Cystitis and Bladder Mass in Two Adults with Chronic Granulomatous Disease

Frederick S. Southwick, MD; and Jos W.M. van der Meer, MD
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Requests for Reprints: Frederick S. Southwick, MD, Infectious Disease Section, 536 Johnson Pavilion/G2, University of Pennsylvania School of Medicine, Philadelphia, PA 19104.

Current Author Addresses: Dr. Southwick: Infectious Disease Section, University of Pennsylvania School of Medicine, Philadelphia, PA 19104.

Dr. van der Meer: Department of Infectious Diseases, University Hospital, 2300 RC Leiden, the Netherlands.

© 1988 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1988;109(2):118-121. doi:10.7326/0003-4819-109-2-118
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Two men, aged 23 and 20 years, with recurrent episodes of severe cystitis and X-linked chronic granulomatous disease were studied. Ultrasonography showed large discrete bladder masses that mimicked bladder carcinoma in both patients. Urine and bladder biopsy cultures were negative and histopathologic findings were consistent with chronic inflammation. One patient improved with symptomatic therapy on two occasions; the other patient required prolonged intravenous antibiotic therapy before fever and dysuria resolved. The possible mechanisms by which such inflammatory bladder masses might arise are discussed and eight previously reported cases of chronic granulomatous disease with cystitis are reviewed. From this clinical experience, we recommend prolonged antibiotic therapy. In patients who fail to respond to antibiotic therapy, steroids may be cautiously administered.





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